Division of Medical Education, Iwate Medical University, Idaidori 1-1-1, Yahaba-Cho, Shiwa-gun, Iwate, 028-3694, Japan.
Department of Health and Welfare, Iwate Prefecture, Morioka, Iwate, Japan.
BMC Geriatr. 2020 Sep 7;20(1):328. doi: 10.1186/s12877-020-01743-0.
Although previous large population studies showed elderly with poor self-rated health (SRH) to be at a high risk of functional disability in Western countries, there have been few studies in which the association between SRH and functional disability was investigated in Japanese community dwellers. The association between SRH and functional disability, defined as certification of the long-term care insurance (LTCI) system, in Japanese elderly community dwellers was examined in this study.
A total of 10,690 individuals (39.5% men, mean age of 71.4 years) who were 65 years of age or more who did not have a history of cardiovascular disease or LTCI certification were followed in this prospective study for 10.5 years. SRH was classified into four categories: good, rather good, neither good nor poor, and poor. A Cox proportional-hazards model was used to determine the hazard ratios (HRs) for the incidence of functional disability among the SRH groups for each sex.
The number of individuals with functional disability was 3377. Men who rated poor for SRH scored significantly higher for functional disability (HR [95% confidence interval]: poor = 1.74 [1.42, 2.14]) while women who rated rather good, neither good nor poor, and poor scored significantly higher for functional disability (rather good =1.12 [1.00, 1.25], neither good nor poor = 1.29 [1.13, 1.48], poor = 1.92 [1.65, 2.24]: p for trend < 0.001 in both sexes).
Self-rated health, therefore, might be a useful predictor of functional disability in elderly people.
尽管之前的大型人群研究表明,西方国家自评健康状况差的老年人功能残疾风险较高,但很少有研究调查日本社区居民中自评健康状况与功能残疾之间的关系。本研究旨在探讨日本老年社区居民自评健康状况与功能残疾(定义为长期护理保险(LTCI)系统认证)之间的关系。
本前瞻性研究共纳入 10690 名(男性占 39.5%,平均年龄 71.4 岁)无心血管疾病或 LTCI 认证史、65 岁及以上的个体,随访时间为 10.5 年。自评健康状况分为四个等级:良好、相当好、一般和较差。采用 Cox 比例风险模型确定各性别自评健康状况组发生功能残疾的风险比(HR)。
共 3377 名个体发生功能残疾。自评健康状况较差的男性发生功能残疾的风险显著较高(HR[95%置信区间]:较差=1.74[1.42, 2.14]),而自评健康状况较好、一般和较差的女性发生功能残疾的风险也显著较高(较好=1.12[1.00, 1.25],一般=1.29[1.13, 1.48],较差=1.92[1.65, 2.24]:p<0.001,均在两种性别中)。
因此,自评健康状况可能是老年人功能残疾的一个有用预测指标。